Organization
MOONLITE, LLC
Active
Other names
dba FirstLight Home Care Pueblo
Organization subpart
No
Provider details
NPI number
Authorized official
JUDY DEVINCENTIS (MEMBER)
(970) 209-0223
Entity
Organization
Contact information
Practice address
805 EAGLERIDGE BLVD STE 120, PUEBLO, CO 81008-2354
(970) 209-0223
Mailing address
805 EAGLERIDGE BLVD STE 120, PUEBLO, CO 81008-2354
(970) 209-0223
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
76356523
—
CO
Enumeration date
06/09/2015
Last updated
01/22/2025
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